Rahab Gikami
@rahabgikami
Experienced clinical case manager specializing in claims, revenue assurance, and care coordination.
KenyaWhat I'm looking for
I am an ambitious and committed Clinical Case Manager with over eight years of experience in medical claims analysis, case management coordination, clinical frontline nursing, and hospital revenue assurance. I deliver quality, cost-effective and safe care, and have successfully cleared substantial claims backlogs while driving pricing and revenue initiatives.
My background includes roles in insurance care management, medical claims analysis, and clinical nursing where I led teams, developed department tools, and championed member education and wellness programs. I bring strong communication, analytical, financial risk assessment, and organizational skills to improve patient outcomes, control costs, and strengthen provider relationships.
Experience
Work history, roles, and key accomplishments
Revenue Assurance Manager
Valley Hospital
Mar 2025 - Present (9 months)
Headed billing, accounts receivables, admissions/discharges and claims teams, cleared a claims backlog of KES 26M in the first two months, and led pricing committee to develop surgical packages to improve revenue.
Care Manager
APA Insurance
Nov 2021 - Feb 2025 (3 years 3 months)
Managed preauthorizations, medical call centre operations and chronic disease management programs, implemented cost-containment and established complaints logging and departmental orientation processes.
Medical Case Manager
Minet Insurance Brokers
Oct 2020 - Oct 2021 (1 year)
Managed provider relationships, performed risk assessments and reporting, appointed providers on value-based contracts, and led fraud, wastage and abuse reduction initiatives while coordinating case management for scheme members.
Medical Claims Analyst
Minet Insurance Brokers
Jan 2017 - Dec 2019 (2 years 11 months)
Analyzed outpatient, inpatient, dental and optical claims against contracts, improved reimbursement processes and TAT, and led the claims team to ensure accurate claims processing and stakeholder communications.
Clinical Nurse
ACK Mt Kenya Hospital
Jan 2015 - Dec 2016 (1 year 11 months)
Provided direct patient care, monitored and documented vital signs, managed medication administration and stock, participated in clinical quality improvements and served as infection prevention nurse.
Education
Degrees, certifications, and relevant coursework
Seven Springs Hub Limited
Advanced Case Management Course, Case Management
2020 - 2020
Completed an Advanced Case Management Course covering fundamentals of case management, analytics, communication, value-based case management, and claims management skills.
KWKenya Medical Training College - Webuye
Diploma in Kenya Registered Community Health Nursing, Community Health Nursing
2010 - 2014
Diploma in Kenya Registered Community Health Nursing obtained from KMTC Webuye, covering community health nursing competencies.
Materi Girls' Centre
Kenya Certificate of Secondary Education, Secondary Education
2006 - 2009
Grade: B
Completed Kenya Certificate of Secondary Education at Materi Girls' Centre with attained grade B.
Tech stack
Software and tools used professionally
Availability
Location
KenyaAuthorized to work in
Job categories
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